Correlations between night eating,sleep quality,and excessive daytime sleepiness in a severely obese UK population

Objective

The relationships between night eating, poor sleep quality, and obesity-related comorbidity in a severely obese UK clinic population is unknown. We used validated tools to identify prevalence and to explore this relationship.

Methods

Consecutive consenting clinic attendees completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Score (ESS), and Night Eating Questionnaire (NEQ) to identify sleep quality, excessive daytime sleepiness (EDS) (a surrogate marker for suspected obstructive sleep apnea [OSA]), and night eating, respectively. Proportions of individuals above and below tool cutoff points were compared. Pearson product moment correlation coefficients examined relationships between total scores.

Results

Reported prevalence from 144 participants (mean body mass index [BMI] 46.9 [9.5] kg/m²; age 44.6 [12.1] years; 68% women) had poor sleep quality (73.0%), suspected OSA (30.8%), and night-eating behavior (2.8%). The strongest correlation between PSQI and NEQ scores (r = 0.54; P < .001) was undiminished after controlling for EDS. Although significantly correlated, PSQI and ESS scores (r = 0.31; P < .001) reduced after controlling for night eating (r = 0.21; P = .02). Correlation between NEQ and ESS scores (r = 0.26; P = .002) was smaller and nonsignificant after controlling for sleep quality (r = 0.12; P = .18).

Conclusions

Poor sleep quality is common in severe obesity, though night eating is rare. The association between poor sleep quality and night eating is not influenced by the presence of EDS.     

Intervention Programs for Children of Parents with a Mental Illness: A Critical Review

There is widespread acknowledgement that children in families affected by parental mental illness are at risk for a range of poor life outcomes. There is also a growing number of interventions to meet the needs of this group of young people. This review evaluates the quality of the existing evidence for such intervention programs. Five hundred and twenty articles were reviewed, and twenty-six studies were judged to be relevant. The majority of the studies were randomised trials (n=8) and pre-post interventions with no comparison or control groups (n=8). None of the studies measured cost-effectiveness or included consumer or carer consultation, and few outlined the theoretical basis for the development of the intervention program. Seven studies were rated as methodologically strong, four as of moderate quality and fifteen as methodologically weak. This data provides very limited evidence of program effectiveness as determined by well-being or illness outcomes for the child. Practitioners should use a recognised theory in developing intervention programs, link program components to identified risk factors for this target group, select intervention components from across the public health spectrum and incorporate greater intersectoral collaboration. Future programs should be rigorously evaluated and widely disseminated, with long-term follow-up of participants.     

Impact of staged InterStim® implantation on the postoperative activities of daily living and pain

Objectives

To evaluate the short-term effects of staged InterStim® implantation on activities of daily living (ADL) and pain.

Methods

This prospective study assessed women undergoing staged InterStim® implantation. The Older Americans Resources and Services Program Multidimensional Functional Assessment Questionnaire asked participants about their ability to complete activities without help or what help they needed following stage I lead placement and stage II neurostimulator implantation. Narcotic use and a visual analog scale (VAS) for pain were recorded daily.

Results

Thirty-eight women underwent stage I with 33 (86.8 %) progressing to stage II. On stage I postoperative day (POD) 2, more women required help shopping compared with baseline (40 vs 17 %, p?<?0.004). The median pain score increased on Stage I POD1 (P?<?0.001) and the use of narcotics increased on POD1 and 2 compared with baseline (50 % vs 14 %, p?=?0.001). The same trends were seen following stage II.

Conclusions

Staged InterStim® implantation has minimal impact on ADL, pain or narcotic requirements.     

Biplane stress echocardiography using a prototype matrix-array transducer.

BACKGROUND: Rapid image acquisition after cessation of exercise is essential for accurate stress echocardiography. Recently, a prototype matrix-array transducer has been developed that allows simultaneous acquisition of 2 imaging planes (biplane [BP] imaging). METHODS: In all, 19 healthy volunteers underwent 2 separate stress echocardiographic studies. Images were acquired in traditional 2-dimensional or BP format pre-exercise and postexercise. RESULTS: Total image acquisition time for 2-dimensional stress echocardiography was 38 +/- 8 seconds versus 29 +/- 8 seconds for BP imaging (P <.05). Heart rates were acquired closer to age-predicted maximum with BP imaging in the apical 3- and 2-chamber and parasternal long- and short-axis views (82%, 75%, 70%, 70% for BP vs 76%, 72%, 68%, 66% for 2-dimensional, respectively). CONCLUSION: BP imaging using a recently developed matrix-array probe allows more rapid imaging postexercise, resulting in acquisition of poststress images at higher heart rates without compromising image quality.     

Determining optimal prostate-specific antigen thresholds to identify an increased 4-year risk of prostate cancer development: an analysis within the Veterans Affairs Health Care System

Purpose

To assess the prostate-specific antigen (PSA) threshold value that optimally predicts future risk of prostate cancer (overall and by race) for a dispersed US population.

Methods

This was a retrospective analysis of men in the Veterans Affairs (VA) Health Care System database. Men ≥ 40 years with a baseline PSA ≤ 4.0 ng/mL, not receiving 5-alpha reductase inhibitors, and without a prostate cancer diagnosis prior to baseline PSA date were included and followed for 4 years. Patients diagnosed with prostate cancer within 6 months of baseline were excluded. The optimal PSA threshold value for future 4-year prostate cancer risk was determined by maximizing Youden’s index.

Results

The eligible population for the final analysis included 41,250 Caucasian (n = 24,518; 59.4 %) and African American (n = 16,732; 40.6 %) patients. The 4-year prostate cancer rate was 3.08 % overall, and race-specific rates were 3.02 and 3.17 % for Caucasian and African American men, respectively. Mean time to prostate cancer diagnosis was 2.01 years across all patients. Race-specific PSA thresholds that optimally predicted future prostate cancer were 2.5 ng/mL [area under the curve (AUC) = 80.3 %] in Caucasians and a 1.9 ng/mL (AUC = 85.4 %) in African Americans; across all patients, a 2.4 ng/mL threshold was optimal (AUC = 82.5 %).

Conclusions

In the VA population, a relatively low PSA threshold of ~2.5 ng/mL was optimal in predicting prostate cancer within 4 years overall and for Caucasian men, but an even lower threshold of 1.9 ng/mL was applicable for African American men.

     

Carcinoembryonic antigen (CEA) in the normal human small intestine: a light and electron microscopic study.

An immunoperoxidase method for the demonstration of carcinoembryonic antigen (CEA) in tissues was applied to formalin-fixed paraffin embedded and glutaraldehyde-fixed resin sections of normal human small intestine. CEA could easily be demonstrated coating the surface of the small intestine, lining the crypts, and in goblet cells, indicating its presence there in considerable concentration. At the ultrastructural level CEA was localised in the glycocalyx and in mucin granules of goblet cells but not intracytoplasmically.     

Anti-Lu14: A Lutheran Antibody Defining the Product of an Allele at the Lu8 Blood Group Locus1

Abstract. A ‘new’ Lutheran-related antibody, named anti-Lu14, reacts with approximately 2.4% of random bloods. Red cells of the rare Lu:-8 phenotype are Lu:14. The data indicate, with a high probability, that the Lu 14 antigen is a product of an allele of Lu⁸ and that Lu¹⁴ and Lu⁸ comprise a third pair of alleles at the Lutheran locus. Red cells of the original Sw (a+) propositus are Lu:14. By coincidence, he has inherited two low-incidence genes. This observation may explain the discrepancy in different families concerning a possible relationship between Sw^a and Lutheran. Pedigree information now suggests that Sw^a is not a Lutheran gene.